The Role of Transanal Endoscopic Surgery for Early Rectal Cancer

Abstract

Transanal endoscopic surgery (TES), which is performed through a variety of transanal endoluminal multitasking surgical platforms, was developed to facilitate endoscopic en bloc excision of rectal lesions as a minimally invasive alternative to radical proctectomy. Although the oncologic safety of TES in the treatment of malignant rectal tumors has been an area of vigorous controversy over the past two decades, TES is currently accepted as an oncologically safe approach for the treatment of carefully selected early and superficial rectal cancers. TES can also serve as both a diagnostic and potentially curative treatment of partially resected unsuspected malignant polyps. In this article, indications and contraindications for transanal endoscopic excision of early rectal cancer lesions are reviewed, as well as selection criteria for the most appropriate transanal excisional approach. Preoperative preparation and surgical technique for complications of TES will be reviewed, as well as recommended surveillance and management of upstaged tumors.

Keywords

transanal endoscopic microsurgery - transanal endoscopic operation - transanal minimally invasive surgery - rectal cancer - transanal endoscopic surgery - pT1 - total mesorectal excision - endoscopic mucosal resection - endoscopic submucosal dissection

Publication History

Article published online:
28 February 2022

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